东莞市一工厂细菌性痢疾爆发的现场流行病学研究

目的了解一起工厂细菌性痢疾（菌痢）爆发的特点和流行原因,积累对爆发疫情调查处理的经验并为制定防治对策提供科学依据。方法采用现场流行病学调查分析和实验室病原分离培养鉴定方法,并结合发病危险因素的病例进行对照研究。结果2006年10月30日至11月4日,该厂发生细菌性痢疾70例,罹患率为1.00%,发病均为工厂民工,年龄16～42岁,病例呈散在分布,无明显宿舍及工种聚集性,临床表现以发热、腹泻、腹痛、粘液血便、里急后重为主。从病人粪便和肛拭标本中分离培养出15株福氏2b型志贺氏菌。病例对照研究食用凉拌粉丝的OR值为7.75,经采取隔离治疗病人、食品卫生管理等综合措施后,疫情迅速终止。结论本次疫情为一起菌痢爆发,爆发原因初步排除水源和接触因素,凉拌粉丝为可疑食物。集体食堂卫生安全存在诸多薄弱环节,加强集体食堂的管理是遏止食物中毒和肠道传染病爆发的关键。

Epidemiological Study of An Outbreak of Bacterial Dysentery in Dongguan City

Objective To analyze the epidemiological characteristics of an outbreak of bacterial dysentery,and to propose a preventive measure.Method Field epidemiological study and case-control study were used.Result 70 cases of bacterial dysentery were found between 30 Oct.and 4 Nov.2006.The attack rate is 1.00%.All the patients are migrant workers and aged between 16 to 42.A clear association between the outbreak and the job nature was not observed.Fever,diarrhea,bellyache,and tenesmus were the major symptoms.Fifteen S.flexneri 2b were isolated from the stool and anal swab from the patients.Individuals consuming cold vermicelli were at high risk of infection(OR=7.75).Conclusion The outbreak of the bacterial dysentery was caused by the consumption of cold dishes,such as cold vermicelli.And also the poor hygienic conditions in the canteen.Good kitchen and personal hygiene are important in preventing the outbreak of bacterial dysentery.